A biased look at psychology in the world

Suicide

December 01, 2016

Police officers are frequently the first responders to individuals in crisis, but generally receive little training for this role. An article recently published in the journal Crisis evaluates training in suicide awareness and prevention for frontline rail police in the UK. A research study investigated the impact of training on officers’ suicide prevention attitudes, confidence, and knowledge using fifty-three participants who completed a brief questionnaire before and after undertaking training. In addition, two focus groups were conducted with 10 officers to explore in greater depth their views and experiences of the training program and the perceived impact on practice. Results showed that baseline levels of suicide prevention attitudes, confidence, and knowledge were mixed but mostly positive and improved significantly after training. Such improvements were seemingly maintained over time, but there was insufficient power to test this statistically. Feedback on the course was generally excellent, notwithstanding some criticisms and suggestions for improvement. The researchers conclude that training in suicide prevention appears to have been well received and to have had a beneficial impact on officers’ attitudes, confidence, and knowledge. Further research is needed to assess its longer-term effects on police attitudes, skills, and interactions with suicidal individuals, and to establish its relative effectiveness in the context of multilevel interventions.

November 25, 2016

The suicide of Robert Stewart, First Marquess of Londonderry on August 12, 1822 probably could have been avoided.

Despite a glorious political career including representing England at the Congress of Vienna, he had become increasingly unpopular at home. His reputation for integrity and honesty had made him numerous political enemies and he went into a decline after the death of his father in 1821. There are different theories over why be became mentally unbalanced (including the possibility that he was suffering from neurosyphilis) but no actual evidence exists.

Suffering from chronic gout pain and agitated over the stormy sessions in Parliament, Stewart became increasingly paranoid. He was heard to say, ""My mind, my mind, is, as it were, gone" and began suspecting friends and colleagues of conspiring against him. His colleagues all saw that Stewart was getting worse and, on the advice of his doctor, he returned to his home in Kent.

Called to an audience with King George IV, Robert Stewart seemed even more agitated than usual and claimed that he was being accused of homosexual conduct (there was no actual evidence of that either). The king promptly notified Stewart's doctor of what had happened. Although the doctor promptly went to Stewart's residence in Kent and took away all of his razors as a safety precaution, it wasn't enough. A penknife had been forgotten in a drawer and, after seeing his wife and the doctor talking together, Stewart used the knife to cut his throat.

The resulting inquest into Robert Stewart's death concluded that the suicide had been committed in a fit of insanity. The family was greatly relieved and with good reason. Under the English common law of the time, the penalty for suicide (known as a felo de se or crime against the self) was, to put it mildly, harsh. If a verdict of insanity had not been brought in, not only would Stewart's property have been confiscated by the Crown, but he would have been denied a religious burial.

Since the deceased could no longer be punished for the crime, the law also called for the body of a suicide to receive what was termed an ignominious burial (children were exempt). This usually involved burying the deceased in a crossroad with a stake driven through the heart (the reasons for this were never clear although it may have related to old superstitions concerning vampires).

While there were no real statistics regarding how often this was actually done (digging up crossroads can be expensive), the threat of family disgrace was very real. Families of suicides often either concealed the actual circumstances of the death or else obtained the all-important medical certificate verifying that the deceased had been mentally unbalanced.

While the verdict ensured that Stewart could be buried with full honours, it placed a double burden on the surviving family members. Not only did they have to cope with the stigma of suicide, but the stigma of insanity as well (and both were considered to be hereditary). It didn't help that Stewart's political rivals and critics used the suicide and the accusations of homosexuality to undermine his reputation (libel laws were a lot looser in those days).

One family member who took Stewart's suicide especially hard was his nephew, Robert Fitzroy. Despite a long and illustrious career (including serving as captain of the H.M.S. Beagle on its fateful voyage), he lived in dread of the "taint of insanity" in his family. He became increasingly depressed in his old age (helped no doubt by the unintended role that he played in Darwin's theory of evolution, but that's another story). In 1865, he cut his throat almost exactly the way his uncle had so many years before.

It was fortunate that he died penniless since the law concerning property forfeiture in suicide wasn't abolished in England until 1870 (although the last ignominious burial was in 1823). Suicide in the United Kingdom didn't actually stop being a crime until the passing of the Suicide Act in 1961.

While attempted suicide is grounds for mandatory psychiatric evaluation in most jurisdictions these days, actual criminal charges are usually reserved for aiding, inciting, or assisting suicide in any way. There are still places where attempted suicide is punishable with a prison sentence (i.e., Singapore and India), but legal sanctions over successful suicides usually focus on issues of neglect on the part of caregivers.

Although many religions view suicide as a mortal sin and have traditionally denied the deceased religious burial, this is slowly passing (some clerics still request proof of mental instability before authorizing religious rites). Fortunately, a stake through the heart is no longer required.

November 10, 2016

Safety plans have been suggested as an intervention for people at risk of suicide. Given the impulsive character of suicidal ideation, a safety plan in the format of a mobile phone application is likely to be more available and useful than traditional paper versions. The study recently published in the journal Crisis describes MYPLAN, a mobile phone application designed to support people at risk of suicide by letting them create a safety plan. MYPLAN was developed in collaboration with clinical psychiatric staff at Danish suicide preventive clinics. The mobile application lets the user create an individualized safety plan by filling in templates with strategies, actions, and direct links to contact persons. MYPLAN was developed in 2013 and is freely available in Denmark and Norway. It is designed for iPhone and Android platforms. As of December 2015, the application has been downloaded almost 8,000 times. Users at risk of suicide as well as clinical staff have provided positive feedback on the mobile application. Support via mobile phone applications might be particularly useful for younger age groups at risk of suicide as well as in areas or countries where support options are lacking. Yet, it is important to examine the effectiveness of this type of intervention.

October 18, 2016

A Bangor, Maine man is facing life in prison for mailing potassium cyanide to a suicidal man living in the U.K. 54-year-old Sidney Kilmartin first came into contact with 49-year-old Andrew Denton when Denton tried to purchase cyanide from him over the Internet. Kilmartin had apparently been operating a fraudulent site in which he represented himself as an "angel of mercy" who sold cyanide to suicidal customers but actually sent them Epsom salts instead.

When Denton first purchased what he believed to be cyanide from Kilmartin and discovered the fraud, he threatened to go to police. To prevent this from happening, Kilmartin sent the real cyanide which Denton then used to commit suicide at his home in Hull, Yorkshire in 2012. His body was found by his niece on New Year's Eve and he was believed to have been suffering from depression. A toxicology report confirmed that he had died of cyanide poisoning and a coroner's inquest ruled that his death was due to suicide.

Kilmartin first obtained the cyanide by posing as a jeweler and persuading a chemical distributor in California to sell him 100 grams of potassium cyanide for $127.56. He then posted an advertisement on a web site for suicidal people offering "industrial grade cyanide" that would be a "a painless and quick way to commit suicide." In all, he received $1050 by selling the cyanide to five customers in all. He was arrested last year over charges that he swindled Denton and the other customers.

during the trial, Assistant U.S. Attorney Halsey Frank told the court that "Sidney Kilmartin targeted vulnerable people who were depressed to the point of suicide to take advantage of... When Andrew Denton had the audacity to complain that Mr Kilmartin had defrauded and taken advantage of him, Mr Kilmartin killed him." Though admitting to the fraud, his attorney cast doubt on the prosecution's case regarding his client's role in Andrew Denton's death. While already pleading guilty to mail fraud and wire fraud, Kilmartin has now been found guilty of mailing "injurious articles resulting in death and witness tampering."

September 13, 2016

Held on September 10 each year, World Suicide Prevention Day is intended to raise awareness of suicide and how it can be prevented. As part of their campaign to promote World Suicide Prevention Day, the International Association for Suicide Prevention (IASP) has established a special website with resources and suggested activities to promote the event and the 2011 theme: "Preventing Suicide in Multicultural Societies".

Based on WHO estimates, approximately one million people a year die by suicide although reliable suicide statistics are often unavailable in many countries. The magnitude of the problem is often masked by the stigma associated with suicide which can lead to the cause of death being concealed by friends or family members. Although risk factors for suicide vary across cultural and demographic groups, typical causes can include unemployment, stigmatisaton, poverty, oppression, and intimidation. Attitudes towards suicide vary widely depending on family dynamics, religious and cultural beliefs, as well as stereotypes relating to the perceived link beween suicide and mental illness. In countries with significant minority populations, national suicide prevention policies often tend to reflect the cultural views of the dominant majority and neglect the special needs and community reaction that suicidal minority members often face.

Experiences of connectedness are important in the mental health and well-being of all people. Thus, communities that are well integrated and cohesive may be suicide preventive.

Educating professionals of health and social services as well as communities in general about how to identify people at risk for suicide, encouraging those who need it to seek help, and providing them with needed and adequate help can reduce rates of suicide. These efforts require both cultural sensitivity and cultural competence.

Methods of suicide vary across cultural contexts, but restricting access to whatever means are commonly employed has been found to be effective in reducing the number of suicides (e.g. safe storage of firearms, pesticides and medicines; restricting access to bridges and high rise buildings commonly used as jumping sites).

Educating the media on how to report on suicide responsibly, and

Providing adequate support for people who are bereaved by suicide.

Suggested activites to promote World Suicide Prevention Day include:

Launching new initiatives, policies and strategies on World Suicide Prevention Day

Holding conferences, open days, educational seminars or public lectures and panels

Writing articles for national, regional and community newspapers and magazines

Placing information on your website and using the IASP World Suicide Prevention Day banner,promoting suicide prevention in one’s native tongue (https://www.iasp.info/wspd/light_a_candle_on_wspd_at_8PM.php)

Organizing memorial services, events, candlelight ceremonies or walks to remember those whohave died by suicide

Lighting a candle, near a window, at 8 PM in support of: World Suicide Prevention Day, suicideprevention awareness, survivors of suicide and for the memory of loved lost ones.

Please consult the IASP website for other suggested activities.

Suicide prevention in multicultural societies need to be targeted as a multicultural effort. Preventing suicide requires the active cooperation of health care professionals, teachers, police, journalists, researchers, religious and cultural leaders, as well as concerned relatives and friends. It's everyone's business and everyone needs to contribute.

August 25, 2016

Examining precursors that will aid in the discovery of individuals who may harm themselves or others has long been a focus of scholarly research. A new research study published in the journal Crisis sets out to determine if it is possible to use the legacy tokens of active shooters and notes left from individuals who completed suicide to uncover signals that foreshadow their behavior. A total of 25 suicide notes and 21 legacy tokens were compared with a sample of over 20,000 student writings for a preliminary computer-assisted text analysis to determine what differences can be coded with existing computer software to better identify students who may commit self-harm or harm to others. Results showed that text analysis techniques with the Linguistic Inquiry and Word Count (LIWC) tool are effective for identifying suicidal or homicidal writings as distinct from each other and from a variety of student writings in an automated fashion. Findings indicate support for automated identification of writings that were associated with harm to self, harm to others, and various other student writing products. This work begins to uncover the viability or larger scale, low cost methods of automatic detection for individuals suffering from harmful ideation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

July 26, 2016

Background: Although people who use the Internet for suicide-related reasons have been found to report significantly higher levels of suicidal ideation, little is known about the characteristics of these users. Aims: To examine the differences between suicidal people who use the Internet for suicide-related reasons and those who do not. Method: Participants were 205 Australian citizens and permanent residents aged 18−24 years who had felt suicidal within the past year. Participants were recruited online through non-mental health-related websites and asked to complete an anonymous online survey. Results: In univariate analyses, suicide-related users reported significantly higher levels of social anxiety and lifetime and past year suicidal ideation than non-suicide-related users, as well as a higher likelihood of future suicide and overall higher risk for suicide. There were no differences on depressive symptoms and perceived social support. Both groups were unlikely to anticipate seeking help from any source and generally perceived similar barriers to offline help-seeking. Multivariate analyses showed that past year suicidal ideation and likelihood of future suicide significantly predicted suicide-related Internet use. Conclusions: Individuals may choose to go online for alternative methods of coping when their suicidal feelings become more severe, demonstrating the need for more online suicide prevention efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

July 22, 2016

It all began on February 11, 1933 when a 21-year old student named Kiyoko Matsumoto committed suicide by throwing herself into the volcanic crater of Mount Mihara on the Japanese island of Izu Oshima. Matsumoto, a student at Tokyo's Jissan College, developed an infatuation with fellow student Masako Tomita. In a poignant letter, she wrote "Dearest, I am bewildered to distraction by the perplexities of maturing womanhood. I can stand the strain no longer. What shall I do? I should like to jump into a volcano." As it happened, Tomita knew just the ideal spot for such a romantic gesture. Since lesbian relationships were considered taboo in Japanese culture at the time, both she and Tomita decided to travel together to the volcano so that Matsumoto could end her life there.

Mount Mihara was already a well-known suicide site since an observation post near the top of the volcanic cone allowed visitors to look straight down into the crater. Even as early as the 1920s, people could commit suicide by jumping into the volcano. Incidents such as this were relatively rare though since there were more practical alternatives including jumping off one of Tokyo's skyscrapers. Unfortunately for Matsumoto, business owners had recently put a stop to high-rise suicides by placing security barriers at the top of those buildings where suicides had taken place. Though determined jumpers could still find accessible buildings, Masako Tomito telling all her friends at school about Matsumoto's death would establish Mount Mihara as a new suicide venue.

Along with the poignant goodbye note she left behind, the story of a young woman ending her life by jumping into a volcano would eventually inspire a series of copycat suicides. Kiyoko Matsumoto's suicide became a media sensation across Japan as news agencies picked up the story and made her a celebrity. Her goodbye note was reprinted in the newspapers and Mount Mihara suddenly attracted a new wave of tourists and curiosity seekers. Masako Tomita became a celebrity as well and, according to a Times news article from 1935, died not long afterward though the cause of death was not given.

To profit from the volcano's new popularity, Jinnojo Hayashi, president of Tokyo Bay Steamship Company set up a daily steamship line to the island where it was located and the observation post near the top of the mountain picked up the new name: "Suicide Point". Visitors wishing to visit the volcano could ride donkeys and horses up the steep mountain so they could look into the lava for themselves. The poor fishing community at the foot of the volcano prospered with the new tourist trade. Though authorities were already becoming alarmed by the prospect of copycat deaths, they did little to discourage it at first (suicide was not illegal under Japanese law). In 1933 alone, 944 people (804 men, 140 women) would jump into the crater. The two years that followed saw an additional 350 suicides and 1386 attempted suicides on Mount Mihara and visitors would often travel there just to watch people jump.

Newspapers also played on Kiyoko Matsumoto's sexual orientation and "lesbian suicide" became a new cultural meme in Japan. Even before Matsumoto's death, suicide was hardly uncommon in women facing problems coming to terms with their sexuality, For lesbians in particular, living in a country with little tolerance for sexual minorities provided few options except for suffering in silence. The rise in suicides among women was alarming enough for Nobuko Jo of the Old Women's Home in Kobe, Japan to establish a national movement designed to prevent further deaths. She helped set up shelters which she called "Wait-a-bits" where people would could reconsider killing themselves. "The pause for reflection is vital," she said in one public statement, "Achieve that and the unfortunate woman generally saves herself. The thing is to ease their hysteria, if only for a few hours, and get them away from hysterical friends." Along with Wait-a-bits, she also established shelters for homeless women across Japan and credited her movement with preventing thousands of deaths.

There was also the romantic aspect of Matsumoto's death which caused Mount Mihara to became a popular spot for mutual suicide pacts (known as shinjuu in Japan). Until the outbreak of World War 2, as many as 45 couples would commit suicide each year by throwing themselves into the volcano. In one shinjuu case from 1956, 27-year old Fumisuke Onodera and 21-year old Chieko Numakura of Tokyo both decided on suicide after learning of Numakura's bone tuberculosis. Though they both jumped into the volcano, they actually landed on a ledge about ten meters (30 feet) above the lava. After reconsidering their suicide decision, Onodera tried to climb out with Numakura on his back though he could not manage to get her out alone. He eventually made it to the top by himself and arranged for her rescue. Though badly burned, they both survived.

The Mount Mihara suicide epidemic eventually ended through enhanced security to prevent suicides and making it a criminal offense to purchase a one-way ticket to the island. While suicide is likely still possible for someone sufficiently determined, there are usually more accessible places available. Even today, suicide in Japan remains a major social issue and the suicide rate is one of the highest in the world. Methods tend to vary (and certain places such as Japan's Aokigahara Forest remain popular) so authorities stay alert to the possibility of copycat suicides following high-profile deaths. In recent years, the suicides of musicians Yukiko Okada and hide triggered small copycat suicide clusters although nothing on the scale following Kiyoko Matsumoto's death.

Still, the rapid rise of suicides in Japan during the 1990s (1998 saw a 34.7% increase from the previous year) and the number of suicides linked to the recent economic downturn has led to a call for stronger action. A new government initiative has been put into place to reduce suicides 20% by 2017 with billions of yen being allocated for anti-suicide measures including greater access to counseling. Though early signs are encouraging, the popularity of internet suicide websites listing different ways of committing suicide using household chemicals demonstrates that the suicide epidemic is far from over.

May 04, 2016

Following the suicide of Japanese pop singer Yukiko Okada in 1986, there was a sharp rise in copycat suicides. Though the suicide rate quickly returned to normal, "Yukiko syndrome" quickly took on a life of its own and the prospect of further copycat deaths was raised whenever a high-profile suicide occurred. And similar cases of copycat suicides following a celebrity death can be found around the world.

Beginning in 1774 when the publication of Johann Goethe's book, The Sorrows of Young Werther, triggered a rash of suicides by impressionable people imitating the book's hero , copycat suicides have been a recurring problem. Dubbed the "Werther effect" after Goethe's book, the role that mass media can play in spreading suicide contagion is still not well-understood. Despite numerous research studies showing a rise in average suicide rates and emergency room admissions for attempted suicide following a celebrity death, nobody is quite sure why this happens.

April 27, 2016

For young people contemplating suicide, the Internet can be a very dangerous place.

Despite numerous websites providing excellent advice about how to find help, there are far too many other sites that actually encourage users to kill themselves. Along with chat rooms and bulletin boards where suicidal ideas and death fantasies can be shared, cases of suicide "voyeurs" who encourage vulnerable people to kill themselves are hardly uncommon. There are also sites providing concrete advice on how to commit suicide including the sale of "suicide kits" as well as instructions on how to make suicides look like accidents. While many of these pro-suicide sites can also provide emotional support, the damage caused by the pro-suicide material vulnerable users come across cannot be underestimated.

One research study looking at young people aged ten to seventeen who are exposed to pro-suicide conversations or images are seven times more likely to have thoughts about killing themselves. Exposure to pro-suicide material can also have an adverse effect on mental health, especially for people experiencing depression. Critics argue that these pro-suicide sites can romanticize suicide and push young people on the edge into carrying out suicidal acts instead of finding professional help. While only a small percentage of hits in an average search for suicide-related material will be to these pro-suicide sites, they are still freely available to anyone motivated to finding them.